关键词: 阿拓莫兰, 肝移植, 供肝, 细胞保护, 缺血损伤, 还原型谷胱甘肽

Abstract:

BACKGROUND: It is an important subject that how to relieve liver injury during perfusion preservation, and the pretreatment for donated liver is considered to be an effective method in this process, however, most studies are limited in animal experiment. Atomolan is a kind of reduced glutathione, which possess bidirection regulation of metabolism and detoxication. 
OBJECTIVE: To study the protective effect of reduced glutathione Atomolan on donor liver injury.
METHODS: Totally 80 patients received liver transplantation in the Liver Transplantation Center, 81 Hospital of Chinese PLA, from May 2003 to August 2006, were divided into the control (n = 42), and Atomolan (n = 38) groups. The perfusion preservation conditions were similar, except 2.4 g glutathione was added into solutions in later group. Adenosine triphosphate (ATP) and malonaldehyde levels in liver tissues were measured, meanwhile, the liver tissues were observed under a light microscope and an electron microscope. Recipient plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin concentrations were assessed at 1 day post-operation.  
RESULTS AND CONCLUSION: Compared with the control group, the liver ATP level of the Atomolan group was markedly increased (P < 0.01), MDA was decreased (P < 0.01), and the concentrations of ALT, AST, as well as total bilirubin were notably decreased (P < 0.01). Under a light microscope, it showed that the degrees of liver swelling histopathologic hepatic alterations were significantly lessened in the Atomolan group. While under an electron microscope, the structure of liver cells of the Atomolan group was clearer and included a higher number of mitochondria (P < 0.01). Results suggested that reduced glutathione has protective effect on donor liver injury during the procedure of hot and cold ischemia and perfusion.